Sunday, May 8, 2016

Putin’s Health Care ‘Optimization’ a Cascading Disaster, Agranat Says

Paul
Goble

Staunton, May 8 – Vladimir Putin’s
health care “optimization” campaign – his euphemism for closing medical
facilities where the numbers of users are too low – is leading to more
abortions, fewer births, higher infant and child mortality, and the demise of social
and economic activity in many Russian regions near the capital, according to
Alisa Agranat.

The Regnum
journalist who earlier this year attracted attention for a story about provincial
hospitals entitled “Fatal Medical Reform: Russia is Not Moscow” (regnum.ru/news/polit/2105968.html)
now offers a new one, “How They are Killing Us: Is It Possible in Russia to
Give Birth for Free and Near Home” (regnum.ru/news/polit/2129510.html).

Agranat writes with despair that “the
struggle of ‘effective managers with health care continues in Russia’s
hospitals and birthing facilities in small cities,” without any discussion with
the local population about its impact. Indeed, she writes, “it is not excluded
that the law about universal free health care soon will be done away with ‘at
the request of the toilers.’”

She surveys the many places in Tula
oblast where facilities have been closed and where people either have to brave
often impassable roads – which themselves can lead to more medical problems –
go to overcrowded facilities in faraway cities, or simply do without medical
care and in the case of many, die.

In one Tula village, Agranat
continues, “health care is clearly seeking to achieve pre-revolutionary ‘heights,’”
but in fact the situation there is worse than under the tsars because not only
are its hospitals and birthing facilities
being closed but there is no money even for visiting nurses and no one is being
trained to work there.

This situation is hitting those at
both ends of the age structure especially hard.Pensioners simply can’t get the care they need and die sooner than they
should, and those who are about to give birth must travel 33 kilometers to
reach any medical help. That may not sound like much, but the roads are so bad
that you can’t travel at night and the bumpiness may lead mothers to give birth
before they can even get to the birthing facility.

Worse, many of the regional
hospitals to which villagers are now forced to go aren’t happy to see their new
patients given that their facilities are already overloaded. At best, those who
come can expect to wait in ever longer lines; at worst, they won’t be treated
at all, all in the name of saving money.

In neighboring Yaroslavl oblast,
Agranat continues, the “optimization” campaign is in full swing, and ever more
hospitals and birthing facilities are being closed.The consequences are echoed in headlines
which at best echo what happened there in “the wild 1990s.”

Among the examples of such
headlines, she gives the following: “A
Woman Almost Gives Birth in a Fire Engine,” “Doctors from Uglich who Refused to
Help a Bleeding Woman from Myshkin Should be Punished,” and “Yaroslavl ‘Optimization’:
7Birthing Facilities Closed, 4 Children
and a Mother with Many Children Die.”

Under the Putin program, Agranat
continues, any birthing facility in which fewer than 500 children are born is
considered “unprofitable” and has been ordered to be closed down. Those who had
expected to go there must go to others further away, and they are sometimes
turned away if their births are expected to be “complicated.”

Despite all this, she says, “the
population complains surprisingly little.”On the one hand, many people there are parents with children who came to
the countryside out of a belief that it would be a better place to raise their
offspring.And on the other, many are
committed Orthodox Christians. But over time, “optimization” is changing their
attitudes.

Orthodox priests, Agranat points
out, are playing a role in this transformation. They have warned that the
destruction of villages by closing birthing facilities will lead to more
abortions and more infant deaths have turned out to be correct.And people in their parishes are taking
notice.

“In Yaroslavl,” the Regnum
journalist writes, “there is a modern perinatal center, but the rods to it are
far from ideal. Often in order to reach a hospital or a birthing facility,
patients need to be in remarkably good health or have the assistance of higher
powers.” And in bad weather, even that is not enough.

One has the impression, Agranat says, that “the population
for whom the state exists is living a separate life. And the population’s only
obligation is to make medical care profitable for the state.”That has led to the departure of people who
can move and the early death of those who can’t.

Family
ties are being broken, and both factories and farms are closing because their
workers can’t get medical care, she points out, arguing that it is “time to reorient”
the country’s medical policies from a short-term concern about profit to a
longer term one in which the birth and growth of health citizens will pay big
dividends in the future.